A prospective study of maternal satisfaction with spinal anaesthesia for caesarian delivery in a tertiary care hospital

Abstract

Introduction: The choice of anaesthesia for any caesarean section depends on multiple factors such as the indication of surgery, urgency of surgery, and patient’s as well as surgeon’s desire. Anesthesiologists always prefer the method which is safe and most comfortable for the mother, least depressant to the newborn and provides the optimal working conditions for the obstetrician, regional anaesthesia fulfils all these criteria. The advantages of regional anaesthesia include an awake mother at delivery, minimal depression of the newborn, and avoidance of the risks of general anaesthesia.Materials and Methods: The study was designed as a cross-sectional survey. Interviews were conducted by the principal investigator and data collected in a standardized questionnaire. The study site was the Department of Anaesthesia, Shimoga Institute of Medical Sciences, Shimoga, general postnatal wards. Between 4000-4600 caesarean sections are performed every year at the hospitals. As the duration of the study was 1 year, the sample size was taken for convenience. The study was conducted from October 2018 to August 2019.Results: A total of 347 questionnaires were filled. Only one of the 347 questionnaires was spoilt, representing 99.7% rate of returns. The study was designed as a prospective cross-sectional survey. The level of satisfaction with involvement of the respondents in decision making was high (92.2%) A large majority of respondents felt that their expectations for caesarean delivery were fulfilled. (95.1%). Satisfaction with spinal anaesthetic technique was good and stood at 80.6%. The overall satisfaction with the birthing experience was high (95.3%). Mothers whose neonates died were more likely to be dissatisfied compared to mothers whose neonates were alive and well. Respondents whose neonates had a poor outcome (i.e. died) were 6.8 times more likely to be dissatisfied with spinal anaesthesia for caesarean delivery. Seven out of the 345 deliveries (0.2%) resulted in death of the newborn. 13.5% of the deliveries resulted in admission of the newborns to the newborn unit.Conclusion: Spinal anesthesia is effective in controlling pain during and immediately after caesarean delivery. Maternal satisfaction with involvement in decision making for caesarean delivery Shimoga Hospital is high. Spinal anaesthesia for caesarean delivery is associated with high levels of met expectations for Childbirth at Shimoga Hospital. Neonatal outcome is an important contributor to maternal satisfaction with caesarean delivery.